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Vertical Transmission of Citrobacter diversus Documented by DNA Fingerprinting

  • Brenda S. Harvey (a1), Thearith Koeuth (a2), James Versalovic (a2), Charles R. Woods (a3) and James R. Lupski (a2) (a4)...



To confirm the vertical transmission of Citrobacter diversus from a mother to her infant and to evaluate the epidemiologic usefulness of a new automated procedure for analysis of polymerase chain reaction (PCR)-generated DNA fingerprints.


Repetitive element-based PCR (rep-PCR) analysis of C diversus isolates from the blood and amniotic fluid of a mother and the blood of her infant was performed. Unrelated C diversus isolates also were characterized and compared with the isolates from mother and infant. DNA fingerprints were generated by gel electrophoresis of PCR products derived from either unlabeled standard repetitive sequence-based oligonucleotide primers or fluorescent primers. The standard rep-PCR fingerprints were analyzed by visual inspection. The fluorescent primers were used in fluorophore-enhanced rep-PCR (FERP), and the FERP DNA fingerprints were analyzed by an Applied BioSystems (ABI) Model 373A laser scanning unit equipped with Genescan 672 software (Applied Biosystems, Inc, Foster City, CA).

Setting and Patients:

A mother and her newborn infant, both with invasive disease due to C diversus, in an urban tertiary-care hospital.


The DNA fingerprints of the maternal blood, amniotic fluid, and infant blood isolates of C diversus were identical by both visual inspection of ethidium bromide-stained agarose gels and computer-aided analysis of FERP patterns. These strains appeared to differ from all but one control isolate, which had been collected 7 years earlier in the same city in which the infant was born.


Vertical transmission of C diversus from mother to infant can occur in utero. Automated analysis of rep-PCR–generated DNA fingerprints derived using fluorescent primers is an objective means for comparing isolates of C diversus and in all likelihood would be useful for other species of bacteria that possess repetitive elements.


Corresponding author

Cullen Professor of Molecular and Human Genetics and Professor of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030-3498.


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1.Kline, M. Citrobacter meningitis and brain abscess in infancy: epidemiology, pathogenesis and treatment. J Pediatr 1988;113:430434.
2.Giacoia, G, West, K. Sepsis with Citrobacter diversus in sick new-borns. Am J Perinatol 1989;6:4954.
3.Graham, D, Band, J. Citrobacter diversus brain abscess and meningitis in neonates. JAMA 1981;245:19231925.
4.Gwynn, CM, George, RH. Neonatal Citrobacter meningitis. Arch Dis Child 1973;48:455458.
5.Gross, RJ, Rowe, B, Easton, JA. Neonatal meningitis caused by Citrobacter koseri. J Clin Pathol 1973;26:138139.
6.Ribeiro, CD, Davis, P, Jones, DM. Citrobacter koseri meningitis in a special care baby unit. J Clin Pathol 1976;29:10941096.
7.Parry, MF, Hutchinson, JH, Brown, NA, Wu, CH, Estreller, L. Gram-negative sepsis in neonates: a nursery outbreak due to hand carriage of Citrobacter diversus. Pediatrics 1980;65:11051109.
8.Graham, DR, Anderson, RL, Ariel, FE, et al.Epidemic nosocomial meningitis due to Citrobacter diversus in neonates. J Infect Dis 1981;144:203209.
9.Williams, WW, Mariano, J, Spurrier, M, et al.Nosocomial meningitis due to Citrobacter diversus in neonates: new aspects of the epidemiology. J Infect Dis 1984;150:229235.
10.Lin, FY, Devoe, WF, Morrison, C, et al.Outbreak of neonatal Citrobacter diversus meningitis in a suburban hospital. Pediatr Infect Dis J 1987;6:5055.
11.Goering, RV, Ehrenkranz, NJ, Sanders, CC, Sanders, WE. Long-term epidemiological analysis of Citrobacter diversus in a neonatal intensive care unit. Pediatr Infect Dis J 1992;11:99104.
12.Morgan, MG, Stuart, C, Leanord, AT, Enright, M, Cole, GF. Citrobacter diversus brain abscess: case reports and molecular epidemiology. J Med Microbiol 1992;36:273278.
13.Morris, JG, Lin, FY, Morrison, CB, et al.Molecular epidemiology of neonatal meningitis due to Citrobacter diversus: a study of isolates from hospitals in Maryland. J Infect Dis 1986;154:409414.
14.Morris, JG, Tall, BD, Kotloff, KL, Sechter, I. Carriage of Citrobacter diversus among young children in Baltimore. Pediatr Infect Dis J 1988;7:294296.
15.Finn, A, Talbot, GH, Anday, E, Skros, M, Provencher, M, Hoegg, C. Vertical transmission of Citrobacter diversus from mother to infant. Pediatr Infect Dis J 1988;7:293294.
16.Versalovic, J, Koeuth, T, Lupski, JR. Distribution of repetitive DNA sequences in eubacteria and application to fingerprinting of bacterial genomes. Nucleic Acids Res 1991;19:68236831.
17.Versalovic, J, Schneider, M, de Bruijn, FJ, Lupski, JR. Genomic fingerprinting of bacteria using repetitive sequence-based polymerase chain reaction. Meth Mol Cell Biol 1994;5:2540.
18.Woods, CR, Versalovic, J, Koeuth, T, Lupski, JR. Analysis of relationships among isolates of Citrobacter diversus by using DNA fingerprints generated by repetitive sequence-based primers in the polymerase chain reaction. J Clin Microbiol 1992;30:29212929.
19.Versalovic, J, Kapur, V, Koeuth, T, et al.DNA fingerprinting of pathogenic bacteria by fluorophore-enhanced repetitive sequence-based polymerase chain reaction. Arch Pathol Lab Med 1995;119:2329.
20.Richard, C, Brisou, B, Lioult, J. Etude taxonomique de Levinea, nouveau genre de la famile des enterobacteries. Ann Inst Pasteur 1972;122:11371146.
21.Kline, MW, Mason, EO, Kaplan, SL. Epidemiologic marker system for Citrobacter diversus using outer membrane protein profiles. J Clin Microbiol 1989;27:17931796.
22.Li, J, Musser, JM, Beltran, P, Kline, MW, Selander, RK. Genotypic heterogeneity of strains of Citrobacter diversus expressing a 32-kilodalton outer membrane protein associated with neonatal meningitis. J Clin Microbiol 1990;28:17601765.
23.Shamir, R, Horev, G, Merlob, P, Nutman, J. Citrobacter diversus lung abscess in a preterm infant. Pediatr Infect Dis J 1990;9:221222.
24.Farr, RW, Khakoo, RA, Maxwell, LP, Hill, RC. Citrobacter pericarditis secondary to a subphrenic abscess. Clin Infect Dis 1994;18:838839.
25.Booth, LV, Palmer, JD, Pateman, J, Tuck, AC. Citrobacter diversus ventriculitis and brain abscesses in an adult. J Infect 1993;26:207209.
26.Woods, CR, Versalovic, J, Koeuth, T, Lupski, JR. Whole-cell repetitive element sequence-based polymerase chain reaction allows rapid assessment of clonal relationships of bacterial isolates. J Clin Microbiol 1993;31:19271931.
27.Eppes, SC, Woods, CR, Mayer, AS, Klein, JD. Recurring ventriculitis due to Citrobacter diversus: clinical and bacteriologic analysis. Clin Infect Dis 1993;17:437440.
28.Versalovic, J, Koeuth, T, Zhang, YH, McCabe, ERB, Lupski, JR. Quality control for bacterial inhibition assays: DNA fingerprinting of microorganisms by rep-PCR. Screening 1992;1:175183.
29.Versalovic, J, Kapur, V, Mason, EO Jret al.Penicillin-resistant Streptococcus pneumoniae strains recovered in Houston: identification and molecular characterization of multiple clones. J Infect Dis 1993;167:850856.
30.Georghiou, PR, Hamill, RJ, Wright, CE, et al.Molecular epidemiology of infections due to Enterobacter aerogenes: identification of hospital outbreak-associated strains by molecular techniques. Clin Infect Dis 1995;20:8494.
31.Georghiou, PR, Doggett, AM, Kielhofner, MA, et al.Molecular fingerprinting of Legionella species by repetitive element PCR. J Clin Microbiol 1994;32:29892994. Bruijn, FJ. Use of repetitive (repetitive extragenic palindromic and enterobacterial repetitive intergenic consensus) sequences and the polymerase chain reaction to fingerprint the genomes of Rhizobium meliloti isolates and other soil bacteria. Appl Environ Microbiol 1992;58:21802187.
33.Endtz, HP, Giesendorf, BAJ, van Belkum, A, Lauwers, SJM, Jansen, WH, Quint, WGV. PCR-mediated DNA typing of Campylobacter jejuni isolated from patients with recurrent infections. Res Microbiol 1993;144:703708.
34.Giesendorf, BAJ, van Belkum, A, Koeken, A, et al.Development of species-specific DNA probes for Campylobacter jejuni, Campylobacter coli, and Campylobacter lari by polymerase chain reaction fingerprinting. J Clin Microbiol 1993;31:15411546.
35.Judd, AK, Schneider, M, Sadowsky, MJ, de Bruijn, FJ. Use of repetitive sequences and the polymerase chain reaction technique to classify genetically related Bradyrhizobium japonicum serocluster 123 strains. Appl Environ Microbiol 1993;59:17021708.
36.Leung, K, Strain, SR, de Bruijn, FJ, Bottomley, PJ. Genotypic and phenotypic comparisons of chromosomal types within an indigenous soil population of Rhizobium leguminosarum bv. trifolii. Appl Environ Microbiol 1994;60:416426.
37.Louws, FJ, Fulbright, DW, Stephens, CT, de Bruijn, FJ. Pathovar-specific genomic fingerprints of phytopathogenic Xanthomonas and Pseudomonas strains generated with repetitive sequences and the polymerase chain reaction (rep-PCR). Appl Environ Microbiol 1994;60:22862295.
38.Lupski, JR, Weinstock, GM. Short, interspersed repetitive DNA sequences in prokaryotic genomes. J Bacteriol 1992;174:45254529.
39.Struelens, MJ, Bax, R, Deplano, A, Quint, WGV, van Belkum, A. Concordant clonal delineation of methicillin-resistant Staphylococcus aureus by macrorestriction analysis and polymerase chain reaction genome fingerprinting. J Clin Microbiol 1993;31:19641970.
40.van Belkum, A, Struelens, M, Quint, W. Typing of Legionella pneumophila strains by polymerase chain reaction-mediated DNA fingerprinting. J Clin Microbiol 1993;31:21982200

Vertical Transmission of Citrobacter diversus Documented by DNA Fingerprinting

  • Brenda S. Harvey (a1), Thearith Koeuth (a2), James Versalovic (a2), Charles R. Woods (a3) and James R. Lupski (a2) (a4)...


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